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Risk profiling and management DES (England)

A summary of what is involved in the risk profiling and management DES for England.

Purpose
Identification and case management of patients identified as seriously ill or at risk of emergency hospital admission.

Applies
From 1 April 2013 and will be reviewed by NHS England for 2014/15 

Payment
£0.74 per patient (£5,175 pa for average list size practice with 6,911 patients)  

What it involves
CCGs can design and manage this DES at local level subject to meeting NHS England’s national minimum requirements under which:  

  • The practice profiles its registered list at least quarterly to identify patients who are or may become at risk of emergency admission.
  • The practice uses a local multi-disciplinary approach to assess such at risk patients to identify those needing active case management under criteria agreed with the CCG.
  • The practice meets the multi-disciplinary professionals at least quarterly to achieve a shared and integrated case management approach.
  • A nominated lead professional is responsible for each case management patient who reviews and discusses care planning with the patient at a frequency agreed with the patient.

Full details: 2013/14 general medical services (GMS) contract - Guidance and audit requirements for new and amended services

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